Provider Demographics
NPI:1497813018
Name:ASSOCIATES FOR WOMENS HEALTH, S.C.
Entity Type:Organization
Organization Name:ASSOCIATES FOR WOMENS HEALTH, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-244-0222
Mailing Address - Street 1:3 S GREENLEAF ST
Mailing Address - Street 2:SUTIE A
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3377
Mailing Address - Country:US
Mailing Address - Phone:847-244-0222
Mailing Address - Fax:847-244-7122
Practice Address - Street 1:3 S GREENLEAF ST
Practice Address - Street 2:SUTIE A
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3377
Practice Address - Country:US
Practice Address - Phone:847-244-0222
Practice Address - Fax:847-244-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042006578036071609207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204116OtherMEDICARE PIN-APN
IL204116OtherMEDICARE PIN-APN